1979, 11-02 Permit: 79-7254 FurnaceI
PLAN NUMBER `
JOB ADDRESS
1.
-3/100
LOT BLOCI
2.
OWNER
3. N` GF
ADDRESS
-3 18
CONTRACTOR ��,��
4. ADDRESS 5 �L
DESIGNER
5. ADDRESS
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
. LEGAL DESCRIPTION - SEE ATTACHED
CHANGE OF USE FROM ITO
6.
PHONE
ZIP
NE
ZIP
PHONE
ZIP
ize of Parcel
I Rec'd.
Zone Classification
FEES COLLECTED
Single $
Type Const.
Occupancy
Sprinklered
I
Plumbing
❑Yes ❑No ❑ Req'd.
'aluation
Building Area in Sq. Ft.
Plan Check
DWL Area
Basement Area
Garage Area
Storage
Mobile Home
Split Entry
Split Level
Rancher
No. Baths No. Floors
TYPE �W ❑ ALT. -1 AD'N. El RPL. 1-1 MVE.
7, OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. [�[`MECH: ❑ M.H. ❑ POOL CERTIFICATE
of EXEMPTION
DESCRIBE WORK
8.
VALUATION Source GAS ELECTRIC WATER SEWER
00 of
9, 0 Utilities
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of. any other state or law regulating construction or the
performance of construction.
DATE SIGNATURl
/J �J , / _
// ^ 1 �T
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
Rouse 1-o k-rf-o A -r xrm- or L4-r
—75,11)aa B -t -U
z —2-0
DATEtj— 2-7/
^OFFICIAL
No. Rooms I Rec. Room
Req'd.
I Rec'd.
Not Req'd
FEES COLLECTED
Single $
Building
Plumbing
Mech9"
Plan Check
SEPA
Mobile Home
Other (Specify)
PERMIT NUMBER
bt -77- 25 -
DATE
*1200
*1200
725,32
11=02-79
za 6.479.
°G
TOTAL $ /a
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS,B,IiCOMES A PE� MIT. e
i _
T.g:7Fi IQ. mrun�eaN:1 a If'r_wtetv,a,n,
yeyw ec'<IVA4 that Y am
making my awa gee etridp :,.' f as a p �l r. � :'z 4 ,41 1,°t my cm bsai l di'aag •" .b d
Further te7Tt fy that A k:+®:`a,
with the Gae Cade ao zmIl a _ all te2Fae :.._:.: ?s, h -a eas, py,5111.e .
etc. v oT it haVIILA0471144rOALIALL7WaL z the requi d
teate loz me upotsa. emplatim f:»2. 5i,l'?4;:.3 . ]t Lot, gnd befe `fA X6"' incl "et ra
st %1Qtien in compliance
A4 dLt'r„: n..
Signed and witneseed a '2_
1972